907.01 Notice of Decision (NOD) SR 17-12 Dated 07/17 (FAM-A)

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the eligibility decision;

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the reason for the decision, if a denial, decrease, or termination of eligibility;

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the eligibility period;

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the maximum income limit for the family size;

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the total gross monthly income amount;

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the income computation used to determine financial eligibility;

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each eligible family member’s name and individual number;

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that funds are now available and the child is released from the wait list, if applicable; and

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the right to appeal.